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cpt code 11046 and multiple units

Messages
2
Location
Belton, TX
Best answers
0
Hello
I am receiving a denial from Medicare stating that I am billing too many units of cpt add on code 11046. The debridements were all to the same depth and covered a surface area of 21cm x 12cm. I billed 11043 1 unit and 11046 12 units. The denial is stating I cannot bill 12 units of 11046. Medicare will not tell me how many units I can bill. The MUEs do not address this code.
Help please
thanks
John
 

espressoguy

Expert
Messages
406
Location
Tacoma, WA
Best answers
0
Medicare will deny greater than 4 total units (11043, 11046x3) as medically unlikely. However, assuming your documentation supports it, it will be paid on appeal.
 
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